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Eyes painful as if pricked by needles indicate a manifestation within the "Shen Chong" syndrome (a category of eye diseases attributed to spiritual or mysterious causes in ancient texts), where the stinging pain is similar to that of moxibustion or needle insertion. However, this condition arises from latent heat-toxin in the Heart and wind pathogen stagnating between the diaphragm. Symptoms include vertigo, headache, frequent tension in the ocular meridians, dryness and pain when attempting to lie down, tearing with difficulty opening the eyes, and intermittent sensations resembling needle pricks. Urgently administer Xie Xin Tang Ba San (Eight-Part Decoction for Draining the Heart) to address head-related symptoms; apply contemporary eye drops to dissipate blood stasis and qi stagnation; and wash the eyes with decoctions of Platycladi Cacumen (Ce Bai Ye), Saposhnikoviae Radix (Fang Feng), Schizonepetae Herba (Jing Jie), Menthae Haplocalycis Herba (Bo He), Coptidis Rhizoma (Huang Lian), and Rehmanniae Radix (Sheng Di Huang). If stars appear on the cornea (Hei Jing) like nails driven in, causing needle-like pain, mild eye drops may be applied.

Exogenous obstructions following typhoid fevers or other acute febrile diseases generally result from leaving bed too early after severe illness has subsided. The body becomes emaciated, the zang-fu organs are not yet solidified, qi and blood remain deficient, and the imbalance of yin and yang has not recovered. Indulging in dietary excesses—such as the five pungent spices, greasy foods, fried items, and all hot-natured substances—leads to the accumulation of various toxins within. Heat pathogens must then manifest externally and attack the eyes. The eyes are the essence of the five zang and six fu organs, and their disorders manifest in the Five Wheels. During an episode, the eyes become red and swollen, tear profusely, suffer from painful dryness making opening difficult, the pupil dilates, visual obscurations (black flowers) are chaotic, and distance vision is impaired; this is due to blood deficiency. The treatment method involves applying contemporary eye drops and washing the eyes with formulas that disperse wind and invigorate blood. Cold-natured washes should be avoided. Instead, one should gently tonify the zang-fu organs, reduce excess, and supplement deficiency. This flexible approach requires dietary restrictions for two to three months.

Question: Why do both eyes sometimes become swollen and painful? Answer: This is caused by insufficient qi and blood, leading to deficient yang attacking upward. Even if pain is present, laxatives or cold-natured medicines must absolutely not be used; only harmonizing methods are suitable. For severe swelling and pain, Ming Mu Xi Xin Tang (Bright Eyes Asarum Decoction), Xiong Dan Wan (Bear Bile Pills), or Di Huang Tang (Rehmannia Decoction) may be taken, along with the application of San Qi Dan.

Ming Mu Xi Xin Tang: Treats eye swelling and pain following febrile diseases, accompanied by constipation and photophobia.
Ingredients: Sheng Di Huang (Rehmanniae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Man Jing Zi (Viticis Fructus), Gui Wei (Angelicae Sinensis Radix Tail), Bai Fu Ling (Poria), Ben Cao (Ligustici Wallichii Rhizoma), Jing Jie (Schizonepetae Herba), Ma Huang Gen (Ephedrae Radix et Rhizoma), Fang Feng (Saposhnikoviae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Chuan Jiao (Zanthoxyli Pericarpium), and Xi Xin (Asari Radix et Rhizoma).
All ingredients in equal parts. Take warm after meals, once daily.

Xiong Dan Wan: Treats diseases caused by liver and gallbladder affected by heat-fire pathogens, functioning to clear heat and detoxify.
Ingredients: Xiong Dan (Ursi Fel), Shi Jue Ming (Haliotidis Concha), Che Qian Zi (Plantaginis Semen), Ze Xie (Alismatis Rhizoma), Xi Xin (Asari Radix et Rhizoma) [each 1 liang], Gan Di Huang (Rehmanniae Radix Preparata), Chong Wei Zi (Leonuri Fructus), Niu Dan (Bovis Fel), and Long Dan Cao (Gentianae Radix).
Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 49 pills per dose, washed down with warm wine after meals.

Di Huang Tang: Treats chronic eye conditions characterized by dimness and dryness that persist long after onset.
Ingredients: Fang Feng (Saposhnikoviae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Ren Shen (Ginseng Radix), Bai Fu Ling (Poria), Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Preparata), Huang Lian (Coptidis Rhizoma), and Huang Qin (Scutellariae Radix).
All ingredients in equal parts. Decoct in water and take warm.